MARIA THERESIA GROSSE-PERDEKAMP MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

ACTIVE

Business

First Name

MARIA

Middle

THERESIA

Last Name

GROSSE-PERDEKAMP

Suffix

Business Name

MARIA THERESIA GROSSE-PERDEKAMP MD

Original Issue Date

08/28/2003

Effective Date

04/25/2023

Expiration Date

07/31/2026

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/25/2023